Abstract The diagnosis of a patent foramen ovale (PFO) is a dynamic process and it is based on the detection of blood shunting at the atrial level. Only under abnormal physiologic conditions, such as with a left ventricular assist device (LVAD), when right atrial pressure (RAP) exceeds left atrial pressure (LAP) the PFO may cause hypoxemia due to a right-to-left shunt. We report the closure of a PFO using a transcatheter approach in a patient on LVAD support. (J Card Surg 2012;**:1-2).